Articles: hospital-emergency-service.
-
Review Meta Analysis
Accuracy and quality of clinical decision rules for syncope in the emergency department: a systematic review and meta-analysis.
We assess the methodological quality and prognostic accuracy of clinical decision rules in emergency department (ED) syncope patients. ⋯ The methodological quality and prognostic accuracy of clinical decision rules for syncope are limited. Differences in study design and ECG interpretation may account for the variable prognostic performance of the San Francisco Syncope Rule when validated in different practice settings.
-
Meta Analysis
Diagnostic accuracy of the TIMI risk score in patients with chest pain in the emergency department: a meta-analysis.
The Thrombolysis in Myocardial Infarction (TIMI) risk score uses clinical data to predict the short-term risk of acute myocardial infarction, coronary revascularization or death from any cause. It was originally developed for use in patients with unstable angina or non-ST-elevation myocardial infarction. We sought to expand the clinical application of the TIMI risk score by assessing its prognostic accuracy in patients in the emergency department with potential acute coronary syndromes. ⋯ Although the TIMI risk score is an effective risk stratification tool for patients in the emergency department with potential acute coronary syndromes, it should not be used as the sole means of determining patient disposition.
-
Trauma, violence & abuse · Apr 2010
Review Meta AnalysisPattern of physical injury associated with intimate partner violence in women presenting to the emergency department: a systematic review and meta-analysis.
To examine patterns of physical injury associated with intimate partner violence (IPV) among women presenting to emergency room departments. ⋯ Among women presenting to emergency room departments, unwitnessed head, neck, or facial injuries are significant markers for IPV. Conversely, extremity injuries are less likely to have been the consequence of IPV.
-
Critical care medicine · Nov 2009
Multicenter Study Meta Analysis Comparative StudyAssociation between timing of intensive care unit admission and outcomes for emergency department patients with community-acquired pneumonia.
To compare the 28-day mortality and hospital length of stay of patients with community-acquired pneumonia who were transferred to an intensive care unit on the same day of emergency department presentation (direct-transfer patients) with those subsequently transferred within 3 days of presentation (delayed-transfer patients). ⋯ Our findings suggest that some patients without major criteria for severe community-acquired pneumonia, according to the recent Infectious Diseases Society of America/American Thoracic Society consensus guideline, may benefit from direct transfer to the intensive care unit. Further studies are needed to prospectively identify patients who may benefit from direct intensive care unit admission despite a lack of major severity criteria for community-acquired pneumonia based on the current guidelines.
-
Ketamine is widely used in emergency departments (EDs) to facilitate painful procedures; however, existing descriptors of predictors of emesis and recovery agitation are derived from relatively small studies. ⋯ Early adolescence is the peak age for ketamine-associated emesis, and its rate is higher with IM administration and with unusually high IV doses. Recovery agitation is not age related to a clinically important degree. When we interpreted it in conjunction with the separate airway adverse event phase of this analysis, we found no apparent clinically important benefit or harm from coadministered anticholinergics and benzodiazepines and no increase in adverse events with either oropharyngeal procedures or the presence of substantial underlying illness. These and other results herein challenge many widely held views about ED ketamine administration.